No abstract available.
Colitis, Ulcerative* ; Ulcer*

Our clinical observation are based on a series of 17 cases with muscular torticollis operated on since 1955 at the Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea. 1. In a series of 4 infants and 13 older children with congential torticollis, a sternocleidomastoid tumor was detected clinically in 4 cases less than 5 months of age and in 5 older patients. 2. The age at the onset of symptoms ranged from one week to 5 years, with an average duration of symptoms of nine and a ha1f years. 3. Results of surgical correction in this series were uniformly good. 4. Secondary changes in these cases of congenital torticollis were improved only when the surgical treatment was given while there was still growth potential. 5. In our series of cases, there was no congenital deformity other than torticollis. 6. On microscopic examination of the pathologic specimen, there was no evidence of hemorrhage or pyogenic infection.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Human ; Infant ; Infant, Newborn ; Male ; Torticollis/*congenital

Many calcifications due to fat encrosis in the buttocks detected on the pelvis roentgenogram suggest that themajorityof injections intended to be intramuscular actually are delivered into fat. We measured thickness of adultgluteal fat to decide whether the injection using needle of usual length is done into fat or muscle. We measuredthe vertical thickeness of the subcutaneous fat at a point of 2-3cm above the femoral head cut slice with randomlycollected 116 cases of adults in the departement of Radiology, St.Mary's Hospital, Catholic Medical College. Wefound that 32% female cases might actually receive on intraadipose injection when a needle of maximum 3.8cm lengthis inserted into the buttock. If deposition into muscle is desirable, we need to choose needle whose length isappropriate for the site of injection and patient's deposits of fat.
Adult ; Buttocks ; Female ; Head ; Humans ; Needles ; Pelvis ; Subcutaneous Fat

PURPOSE: To report the decreasing incidence of HBV(Hepatitis B virus)-associated membranous nephropathy in children after HBV vaccination and to elucidate the clinical course and treatment strategies of IMN (Idiopathic membranous nephropathy). METHODS: We retrospectively reviewed the clinico-pathological findings of HBV-MN and IMN patients who underwent a renal biopsy from 1986 to 2005. We compared the HBV-MN and the IMN groups and the remission and the non-remission groups of patients with IMN. RESULTS: Among 24 cases of MN patients, HBV-MN comprised 6 cases(25%) and IMN 18 cases(75%). Clinical masnifestations were nephrotic syndrome(3 cases, 50%), nephritic syndrome(1 case, 16.7%), asymptomatic(2 cases, 33.4%) in the HBV-MN group, asymptomatic(10 cases, 55.5%), nephrotic syndrome(5 cases, 27.8%), and gross hematuria(3 cases, 16.7%) in the IMN group. From 1996 to 2000, there were 2 cases(28%) of HBV-MN and 5 cases(72%) of IMN. After 2001, all 10 cases were IMN. In the HBV-MN group, 4 cases(66.7%) received interferon and 1 case received methylprednisolone pulse therapy. In the IMN group, 16 cases (88.9%) received methylprednisolone, 8 cases(44.4%) were in complete remission, 2 cases (11.1%) were in partial remission, 2 cases(11.1%) were in chronic renal failure, and 5 cases (27.8%) were lost to follow-up with sustained proteinuria, 1 case(5.6%) continued to have frequent relapse of nephrotic syndrome without renal insufficiency. In the comparison between remission and non-remission groups, nephrotic range proteinuria and hypertension were more significantly common in the non-remission group(P<0.05). CONCLUSION: With HBV vaccination, HBV-MN has decreased markedly. IMN is a rare glomerular disease in children. Because the prognosis for patients with nephrotic range proteinuria is poor, this group needs more aggressive treatment.
Biopsy ; Child* ; Glomerulonephritis, Membranous* ; Humans ; Hypertension ; Incidence ; Interferons ; Kidney Failure, Chronic ; Lost to Follow-Up ; Methylprednisolone ; Nephrotic Syndrome ; Prognosis ; Proteinuria ; Recurrence ; Renal Insufficiency ; Retrospective Studies ; Vaccination

OBJECTIVE: To determine the usefulness of neonatal nucleated red blood cell counts (nRBC) as an independent predictor of fetal hypoxia and perinatal outcome in severe preeclampsia. METHODS: One hundred thirty eight patients with severe preeclampsia were studied. Umbilical artery Dopppler velocimetry was performed in all patients, and were divided into two groups, the control group with present umbilical artery end diastolic velocity, and the case group with absent or reversed velocity. The patients were also separately grouped as another control (n=58), acute (n=19), and chronic hypoxia (n=55) according to abnormal Doppler findings, presence of oligohydramnios, intrauterine growth restriction (IUGR), and pattern of fetal heart rate tracings during labor. At delivery, the umbilical cord blood was collected and the levels of nRBC per 100 WBC were measured from the samples along with blood gas analysis. The results were compared between the control and acute groups, and chronic hypoxic fetus. Correlation with perinatal outcomes was also evaluated. Student's t-test, ANOVA, and regression analysis were performed for statistical analysis. RESULTS: Those with absent or reversed end diastolic velocity did not have significantly greater nRBC counts, but had lower platelet counts (p=0.02), lower pO2 (p=0.005), and higher pCO2 saturation levels (p=0.01). There were no significant differences with regard to nRBC counts among the control, acute, and chronic hypoxia groups. Elevated nRBC counts were significantly associated with neonatal intensive care unit stay of more than 28 days (p=0.013), respiratory distress syndrome (p=0.003), disseminated intravascular coagulopathy, or sepsis (p=0.041). CONCLUSION: nRBC counts did not show significant difference according to umbilical artery Doppler velocity. Also we could not find any difference between the control, acute, and chronic hypoxic group, suggesting that nRBC counts does not correlate with both hypoxic status, or duration of hypoxia. Correlation with elevated nRBC counts and neonatal intensive care unit stay of more than 28 days, respiratory distress syndrome, disseminated intravascular coagulopathy, and sepsis was observed. However, the overlapping results and the wide range of nRBC counts according to the complications limits its role as a predictor of poor perinatal outcome.
Anoxia ; Blood Gas Analysis ; Erythrocyte Count ; Female ; Fetal Blood ; Fetal Hypoxia* ; Fetus ; Heart Rate, Fetal ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Oligohydramnios ; Platelet Count ; Pre-Eclampsia* ; Pregnancy ; Rheology ; Sepsis ; Umbilical Arteries

When the cervical cancer is diagnosed in early stage during pregnancy, the treatment can be postponed for fetal viability. This case presents a patient diagnosed as cervical cancer stage Ib1 during her pregnancy. The patient had 2 cycles of neoadjuvant chemotherapy (Paclitaxel-cisplatin) formerly and cesarean section was done at 33rd weeks of intrauterine pregnancy, then radical abdominal hysterectomy with bilateral pelvic lymph node dissection and paraaortic lymph node biopsy was immediately performed right after the delivery. For the baby born, there was neither complication nor congenital anomaly but mild bilateral ventriculomegaly seen on brain CT taken on 3 days after birth. This case offers a better chance for both mother and fetus while conserving fetal viability and managing the early cervical cancer during pregnancy through close follow up.
Biopsy ; Brain ; Cesarean Section ; Drug Therapy* ; Female ; Fetal Viability ; Fetus ; Follow-Up Studies ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Mothers ; Parturition ; Pregnancy* ; Uterine Cervical Neoplasms

The passage of decidual cast in pregnancy is rare and mostly associated with some kind of congenital uterine malformation. Since the hemorrhage caused by the passage of decidual cast can easily be mistaken for other causes of the antepartum hemorrhge, it often leads to the premature delivery of the baby which results poor perinatal outcome. Moreover it mostly happened nonpregnant horn in didelphic or bicornuate uterus, although decidual cast was expelled. We have experienced a case of woman with didelphic uterus and past history of two consecutive premature deliveries, who delivered a female baby at 38 gestational weeks through intensive care after expelling decidual cast in pregnant uterus at 30 gestational weeks. We present this case with a brief review of literatures.
Animals ; Female ; Hemorrhage ; Horns ; Humans ; Critical Care ; Pregnancy ; Pregnancy Trimester, Second* ; Uterus*

PURPOSE: This study aimed to identify multidimensional factors influencing burnout in intensive care unit(ICU) nurses. METHODS: A descriptive cross-sectional design was used. Data were collected during February 2016 from a convenience sample of 222 tertiary hospital ICU nurses and analyzed using t-test, ANOVA, correlation analysis, and multiple regression analysis. RESULTS: Burnout correlated positively with compassion fatigue (CF)(r=.37, p < .001), and negatively with compassion satisfaction (CS)(r=-.66, p < .001). The regression model explained 57% of the variance in burnout. For individual characteristics in the model, perceived health status (β=-.27, p < .001) and gender (β=.14, p=.028) were the most influential factors for ICU nurses' burnout. In the model with added work-related characteristics, nursing environment (β=-.22, p=.001), perceived health status (β=-.20, p=.001), and satisfaction with department (β=-.19, p=.007) were the most influential factors. Finally, for the model with psychological characteristics added, CS (β=-.56, p < .001) and CF (β=.35, p < .001) were the most influential factors. CONCLUSION: Results reveal that most ICU nurses have a moderate level of CF and a moderate to high level of CS and burnout, and that individual, work-related and psychological factors are relevant in ICU nurses' burnout. Programs or interventions to reduce burnout should be developed taking into account these multidimensional factors.
Compassion Fatigue ; Critical Care ; Empathy ; Intensive Care Units ; Nursing ; Personal Satisfaction ; Psychology ; Tertiary Care Centers

OBJECTIVE: Although increased expression of receptor for advanced glycation end products (AGE) in osteoarthritis (OA) has been reported, little is known concerning the role of AGEs in the pathogenesis of OA. This study was undertaken to determine the effect of AGEs on the regulation of matrix metalloproteinase (MMP) expressions and activities in human OA chondrocytes METHODS: OA chondrocytes were treated with increasing doses of AGE-bovine serum albumin (AGE-BSA). The expressions of MMPs were determined by both enzyme-linked immunosorbent assay (ELISA) and immunoblot analysis. The activities of MMPs were evaluated by both gelatin and casein zymography assays. In addition, electrophoretic mobility shift assay (EMSA) was employed to investigate the DNA binding activity of nuclear factor-kappa B (NF-kappaB) by AGE-BSA treatment. RESULTS: The productions of MMP-1, -3, and -13 were significantly elevated by AGE-BSA in a dose dependent manner. The elevated activities of MMP-1, -3, and -13, and TNF-alpha by AGE-BSA were also observed. DNA binding activity of NF-kappaB was markedly increased by AGE-BSA treatment implicating possible involvement of NF-kappaB mediated pathway in the AGE-BSA induced MMP-1, -3, and -13, and TNF-alpha productions in OA chondrocytes. Taken together, this study demonstrates the stimulatory effect of AGE-BSA on the productions of MMPs and TNF-alpha and suggests the possible involvement of NF-kappaB mediated pathway in OA chondrocytes. CONCLUSION: These results suggest that AGE may play a role in pathogenesis of OA.
Caseins ; Chondrocytes* ; DNA ; Electrophoretic Mobility Shift Assay ; Enzyme-Linked Immunosorbent Assay ; Gelatin ; Glycosylation End Products, Advanced* ; Humans* ; Matrix Metalloproteinases* ; NF-kappa B ; Osteoarthritis ; Serum Albumin ; Tumor Necrosis Factor-alpha

PURPOSE: Allergic rhinitis (AR) is a multifactorial disease whose genetic and environmental risk factors have been studied for decades. Many pediatric studies have pointed out the familial history of allergy, hygiene hypothesis, breast-feeding, pet ownership, and diets as risk factors of AR. However, most of factors are still up for debate. This preliminary report aimed to confirm the known risk factors and find the novel risk factors for AR in the Korean pediatric population. METHODS: A bi-seasonal, winter and summer, study in 2 elementary schools included all students whose parents completed the questionnaire of medical and social histories, quality of life, infant and early-childhood history, and the living styles. Skin prick tests and endoscopic examinations were conducted on all participants. RESULTS: Among total 1,020 children, 338 participants had AR. The multivariate logistic regression analysis highlighted 6 factors: male gender (OR, 2.10; 95% CI, 1.32-3.33), older age (1.65; 1.03-2.65), previous history of allergic conjunctivitis (14.25; 4.99-40.74), asthma (2.73; 0.96-7.76) and pneumonia (0.39; 0.19-0.82), and an hour increase in daily playing time (0.90; 0.80-1.00). CONCLUSIONS: Lack of pneumonia in early childhood and short playing time are newly found risk factors for Korean pediatric AR in this study confirming male gender, older age and previous history of allergic conjunctivitis and asthma as the risk factors.
Asthma ; Child* ; Conjunctivitis, Allergic ; Diet ; Humans ; Hygiene Hypothesis ; Hypersensitivity ; Infant ; Logistic Models ; Male ; Ownership ; Parents ; Pneumonia ; Quality of Life ; Rhinitis* ; Risk Factors* ; Skin ; Surveys and Questionnaires